Individual provider Active NPI

Aya Hassan Harb

  • Medical Physician Assistant
  • Tempe, AZ
National Provider Identifier
1144796871
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
7566 Issued in AZ
Practice address
1634 S Priest Dr Ste 101
Tempe, AZ 85281-6499
Phone
(480) 821-3600
Fax
(480) 857-2667
NPI assigned
Oct 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7566 AZ
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X 7566 AZ Primary

Addresses

Primary practice location

1634 S Priest Dr Ste 101
Tempe, AZ 85281-6499

Mailing address

PO Box 6730
Chandler, AZ 85246-6730
Phone (480) 821-3600

Other identifiers 1

IdentifierTypeStateIssuer
000318MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200131002718 AZ Practitioner - Physician Assistant 1052747599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Momdoc LLCGroup PAC ID 3375534282, 62 clinicians

Practice addresses (Care Compare)

Chandler, AZ 85224
Phone (480) 821-3600

1634 S Priest Dr
Suite 101
Tempe, AZ 85281-6499
Phone (480) 821-3600

21300 N John Wayne Pkwy
Maricopa, AZ 85139-8978
Phone (480) 821-3600

7342 E Thomas Rd
Suite 105
Scottsdale, AZ 85251-7243
Phone (480) 821-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7566AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Pregnancy Perinatology, LLC PastSince Mar 7, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1144796871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6730",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466730",
            "telephone_number": "480-821-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 S PRIEST DR STE 101",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852816499",
            "telephone_number": "480-821-3600",
            "fax_number": "480-857-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARB",
        "first_name": "AYA",
        "middle_name": "HASSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-20",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7566",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "7566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000318",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.